OBJECTIVE: To establish whether or not patients on continuous ambulatory peritoneal dialysis (CAPD) using current infection control measures who are nasal carriers of Staphylococcus aureus are at risk for the development of S. aureus peritonitis. DESIGN: A prospective 22-month study analyzing nasal and skin/nasal (i.e., nasal and/or exit-site) carrier status for S. aureus and peritonitis episodes. Nasal swab cultures for S. aureus were taken with 1- to 3-month intervals; swab cultures from the catheter exit site were taken only when infection was suspected. SETTING: Renal unit, tertiary-care center. PATIENTS: All patients on CAPD at our center that could be observed during at least 2 months. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Nasal and skin/nasal carrier status, occurrence of peritonitis. RESULTS: Of 54 enrolled patients, 31 (57%) were nasal carriers for S. aureus: 6 of these 31 developed S. aureus peritonitis as opposed to none of 23 non-carriers (p = 0.03). The S. aureus peritonitis rate in 28 skin/nasal carriers was increased when compared to non-carriers (p = 0.02), but there was no difference between chronic and intermittent skin/nasal carriers (p = 0.63). CONCLUSIONS: In our population, nasal carriers are at increased risk for the development of S. aureusperitonitis. Further studies should evaluate the effect of eradication of nasal carriage of S. aureus and the effect of additional preventive hygienic measures on the occurrence of peritonitis by S. aureus.

This article has been cited by other articles:

				C.-C. Szeto, K.-M. Chow, B. C.-H. Kwan, M.-C. Law, K.-Y. Chung, S. Yu, C.-B. Leung, and P. K.-T. Li Staphylococcus aureus Peritonitis Complicates Peritoneal Dialysis: Review of 245 Consecutive Cases Clin. J. Am. Soc. Nephrol., March 1, 2007; 2(2): 245 - 251. [Abstract] [Full Text] [PDF]

				J. Nouwen, J. Schouten, P. Schneebergen, S. Snijders, J. Maaskant, M. Koolen, A. van Belkum, and H. A. Verbrugh Staphylococcus aureus Carriage Patterns and the Risk of Infections Associated with Continuous Peritoneal Dialysis J. Clin. Microbiol., June 1, 2006; 44(6): 2233 - 2236. [Abstract] [Full Text] [PDF]

				T. Lobbedez, M. Gardam, H. Dedier, D. Burdzy, M. Chu, S. Izatt, J. M. Bargman, S. V. Jassal, S. Vas, J. Brunton, et al. Routine use of mupirocin at the peritoneal catheter exit site and mupirocin resistance: still low after 7 years Nephrol. Dial. Transplant., December 1, 2004; 19(12): 3140 - 3143. [Abstract] [Full Text] [PDF]

				S. J. Peacock, G. D. I. de Silva, A. Justice, A. Cowland, C. E. Moore, C. G. Winearls, and N. P. J. Day Comparison of Multilocus Sequence Typing and Pulsed-Field Gel Electrophoresis as Tools for Typing Staphylococcus aureus Isolates in a Microepidemiological Setting J. Clin. Microbiol., October 1, 2002; 40(10): 3764 - 3770. [Abstract] [Full Text] [PDF]

				S.J. Peacock, S. Mandal, and I.C.J.W. Bowler Preventing Staphylococcus aureus infection in the renal unit QJM, June 1, 2002; 95(6): 405 - 410. [Full Text] [PDF]

				S. Pastan and J. Bailey Dialysis Therapy N. Engl. J. Med., May 14, 1998; 338(20): 1428 - 1437. [Full Text] [PDF]

Copyright © 1996 by Multimed Inc.